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Acupressure-
Category: bodywork
Description: Acupressure is the application of manual pressure over traditional Chinese acupuncture points to effect an improvement in pain and illness. The understanding among practitioners is that this technique sends a signal to the body to "turn on" a self-healing or regulatory mechanism. According to traditional Chinese medicine, Qi (vital energy) circulates through natural pathways in the body called meridians, while blockage of this flow or imbalance of Yin and Yang causes illness and pain. Acupressure helps to correct functional imbalances in the energy flow.
History: part of Traditional Chinese Medicine for over 2000 years. Application of pressure to these points during massage is called Shiatsu. Many Asians self administer acupressure in points described below.
Touted Uses: Over 50 diseases and conditions, but mainly used for pain, nausea, and sleep.
Training: Whereas most people self-administer acupressure in the Eastern world, those in the West are unfamiliar with its application and therefore some training is required. Online, there is a variety of explanations of acupressure points. However, for those wanting to become practitioners, there is an acupressure institute that has paid training courses online and sells several books on acupressure, and is a member of the National Certification Board for Therapeutic Massage and Bodywork. There is little medical evidence acupressure has all the health benefits it touts.
Protocols: Use deep, firm pressure to massage and stimulate each point for 5 seconds while relaxing in a comfortable position with your eyes closed and deep breathing. There is no limit to the number of times per day acupressure may be used. Others can be shown where to massage the acupressure points. Some of the more commonly used points are:
Feng Chi- used for treatment of headaches, migraines, eye blurriness or fatigue, low energy, and cold/flu symptoms. It is located by finding the mastoid bone (just behind and below the ear) then sliding the finger towards the back of the head in the groove under the skull until the point where the posterior neck muscles meet the skull. This is also called Gallbladder 20 or GB20 point
Jian Jing- This point is used for stress, facial pain, headaches, toothaches, and neck pain. It is located by pinching the muscles of the shoulder, half way between the shoulder joint and the neck. The point lies about 1-2 inches below the crest of this muscle on the back side. It is also called Gallbladder 21 (GB21) point.
He Gu- Used for treatment of stress, headaches, toothaches, facial pain and neck pain, it is also called Large Intestine 4 (LI4) point. It should not be used during pregnancy. It is located at the base of the webbing of the first finger and thumb, more towards the metacarpal.
Tai Chong- A treatment for stress, low back pain, high blood pressure, limb pain, insomnia and emotional upset. It is located on top of the foot between the first and second metatarsals, closest to the ankle side of where the two metacarpals meet. It is also called the Liver 3 (L3) point.
Nei Guan- Also called Pericardium 6 (P6), this point can help provide relief for the conditions nausea, anxiety, carpal tunnel syndrome, upset stomach, motion sickness, and headaches. It may be used to relieve heart palpitations. It is located by turning the palm up, then measuring three fingerbreadths from the wrist crease towards the elbow. The point is located between the two tendons just to the medial side of the midline of the forearm.
Zhong Zhu- The "Triple Energizer 3" point, is used for temporal headaches, shoulder and neck tension, and upper back pain. It is located on the back of the hand just above the knuckles in the groove between the 4th and 5th finger (between the metacarpals) Avoid in pregnancy.
San Yin Jiao- Also called Spleen 6 (SP6), this point is used for many urological and pelvic disorders in addition to insomnia and fatigue. It is located 4 fingerbreadths above the inner ankle bone (medial malleolus) in the grove behind the tibia and muscle. Avoid in pregnancy.
Zu San Li- This point is useful for fatigue and depression, knee pain, and GI discomfort. It is also frequently stimulated for general health promotion and longevity. It is also called the Stomach36 (ST36) point and is located 4 finger widths from the bottom of the kneecap on the anterolateral aspect of the tibia.
Levels of Evidence (Note: Extreme caution must be used in interpreting Chinese studies that do not use evidence based medicine, frequently co-mingle techniques and do not report these, and their studies are frequently not reproducible in the West)
ALPHA LEVEL:
-Acupressure reduces chemotherapy induced nausea and vomiting [CHINESE STUDY]- The severity of nausea was reduced but not the incidence or frequency of vomiting (Int J Nurs Stud 2017 May;70:27-37)
-SP6 acupressure point is effective for up to 3 hours for relief of pain from primary dysmenorrhea symptoms (menstrual pain) but only when a trained person administered the treatment (Complement Ther Clin Pract 2016 Nov;25:92-105)
-Very low quality of evidence for short term effects of acupressure for treatment of fatigue, sleep disturbance, depression and itching in dialysis patients (Cochrane Database Syst Rev. 2016 Jun 28;(6):CD009440)
-Low quality evidence exists for reduction of postoperative nausea and vomiting by acupressure applied to the PC6 point of the wrist. There is no difference in outcome of acupressure vs antiemetic drugs (Cochrane Database Syst Rev. 2015 Nov 2;(11):CD003281)
-There is moderate evidence acupressure at the EX-HN3 (Yintang) or HT7 (Shenmen) point are effective in reducing anxiety in adults (Acupunct Med 2015 Oct;33(5):353-9)
-Acupressure may be effective for chronic neck and low back pain (PLoS One 2015 Feb 24;10(2):e0117146)
-There is fair evidence to support the use of acupressure in the treatment of chronic low back pain (Neuromodulation 2014 Oct;17 Suppl 2:24-30)
-Low level evidence exists to support use of acupressure to reduce labor pain (Cochrane Database Syst Rev 2011 Jul 6;(7):CD009232)
-Low level evidence exists to support the use of acupressure in treatment of post-stroke symptoms and very low evidence to support its use in headache management (Int J Neurosci 2011 Aug;121(8):409-14)
BETA LEVEL:
-Self administered acupressure for insomnia produced a better Insomnia Severity Index score than sleep hygiene education (J Sleep Res 2018 Apr;27(2):220-231)
-Acupressure vs patient education had equivalent outcomes in the treatment of Raynauds phenomenon (J Scleroderma Relat Disord. 2016 May-Aug;1(2):226-33)
-Acupressure with ear seeds reduces chronic low back pain by 56% and improves physical function by 26%. The sham group reported a 9% reduction in pain and 2% improvement in physical function. There were significant differences in IL-4 and CGRP levels detected suggesting acupressure acts through an anti-inflammatory mechanism (Evid Based Complement Alternat Med 2015;2015:103570)
-Auricular acupressure reduced chronic low back pain by 44% in a one month trial with once weekly treatments. (Pain Med 2015 Oct;16(10):1857-69)
RECOMMENDATION: Two thumbs up. This is inexpensive, may be performed by the patient, and has no significant harms associated outside of the caution to avoid use in pregnancy.